| NPI | 1215925631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ME MD11491) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH NH-8161) |
| 2086S0129X Surgery, Vascular Surgery (Licence: ME 011491) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: NH NH-8161) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: ME MD11491) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2013-09-18 |